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With Shinseki out, what’s Congress going to do about the VA?

VA Secretary Eric K. Shinseki leaves after saying goodbye to Senate Veterans' Affairs Committee Chairman Bernard Sanders (I-Vt.), right, and Sen. Richard Burr (R-N.C.). (Chip Somodevilla/Getty Images)

So now what?

That's what many in Washington will be asking this week now that Veterans Affairs Secretary Eric K. Shinseki has resigned, a move that lawmakers agreed was a good "first step," but just part of a new push to overhaul the beleaguered Department of Veterans Affairs.

With Shinseki's sudden departure, it's likely that Congress will take weeks, if not months, to sort out the situation. The debate will break down along familiar lines -- Democrats and Republicans agree in principle that something must be done, but the House and the Senate can't agree on how to do it. Senate Democrats are pushing to pass a comprehensive bill with several changes, while House Republicans are touting nine veterans-related measures that they've passed in recent months and seen ignored by the Senate.

Meanwhile, the issue of veterans' care is fast becoming fodder on the campaign trail, with Democratic and GOP political operations already targeting incumbents and challengers for ignoring the VA scandal or voting against VA budget increases.

On Sunday, Senate Veterans' Affairs Committee Chairman Bernard Sanders (I-Vt.) introduced a far-reaching proposal to overhaul health care for veterans. The Restoring Veterans' Trust Act would give the VA secretary the authority to remove senior officials based on poor job performance; grant VA expedited hiring authority for nurses and doctors; authorize the department to lease 27 new facilities in 18 states and Puerto Rico; mandate a software upgrade for the department's patient scheduling system by March 2016; and expand opportunities for eligible veterans to seek outside care if VA facilities are unavailable.

"The truth is that when people get into the VA, the quality of care is good," Sanders said Sunday on CBS's "Face the Nation." "The problem that we have to address is access to the system and waiting lines."

A hearing on Sanders's bill will be held Thursday -- meaning it will be at least another week before the full Senate starts debating the measure. The legislation includes language that would make it easier for the next VA secretary to fire or demote senior managers, a proposal that easily passed the House two weeks ago. A coalition of Democratic and Republican senators is backing the proposal as a standalone measure, but Sanders and Democratic leadership aides seem inclined to include it in a larger bill.

In an interview late last week as he was finalizing his proposal, Sanders said that he supports the idea of making it easier to punish poor-performing managers but that he wants to ensure that it wouldn't lead to the politicization of the VA.

"The nightmare could be under the current bill that passed the House that a new president comes in and they fire hundreds of high-ranking VA officials without due process or particular reason," Sanders said. "I think you cannot run a health-care system the size of the VA like that. You want to be able to get rid of people at the VA who are incompetent in a very rapid way, but you have to have due process."

Meanwhile, Republicans including Sens. John McCain (Ariz.) and Richard Burr (N.C.) have said they will introduce a series of proposals as early as Tuesday,  but they've been tight-lipped about what they might include. McCain said Sunday on "Face the Nation" that he supports giving veterans the option to seek medical care from non-VA doctors.

"Why should a veteran have to get into a van and ride three hours to get to Phoenix in order to have routine medical care taken care of?" he said. "Why doesn't that veteran have a card and go to the caregiver that he or she needs and wants?"

House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) is working on legislation that would allow VA-eligible veterans to seek care outside the system if they have to wait more than 30 days to seek medical treatment. The idea of at least partly privatizing veterans' health care, or at least giving them the option to go outside the system, is popular among members of both parties.

“VA has a very important role," Miller told reporters last week. "There are so many things that VA does well and only VA can do and that’s to care for those who have in fact borne the battle, that have the wounds of traumatic brain injury and post-traumatic stress, amputations, spinal cord injuries. The VA should be able to take care of those. But there are some things that you can do in the private sector and the veteran needs to have the option.”

The Sanders bill also addresses a host of issues not directly raised by recent allegations that led to Shinseki's ouster. His measure would expand dental care for veterans; restore full cost-of-living adjustments for military retirement pensions; provide assistance to veterans who were sexually assaulted or raped while serving; and require advance, multi-year appropriations for VA operations. In the House, several of those issues have been part of smaller bills that have passed in recent months.

House Republicans are expected to highlight the measures when they meet with constituents this week during a week-long recess. A tally provided by the House Veterans' Affairs Committee lists nine bills passed in recent months to address veterans' education, employment and health issues. There's the GI Bill Tuition Fairness Act of 2014, which would provide tuition assistance to military service members who joined the ranks after the Sept. 11, 2001, terrorist attacks. The Ruth Moore Act would allow veterans who were sexually assaulted or raped while serving in uniform to receive service-connected benefits and treatment for mental-health conditions linked to sexual trauma. There's also a bill that would make it easier to fire or demote senior VA employees responsible for mismanaged or delayed care, as well as Miller's forthcoming proposal allowing veterans to go outside the VA system.

With elections nearing, the Democratic Senatorial Campaign Committee is targeting at least seven GOP Senate candidates -- in Arkansas, Colorado, Kentucky, Louisiana, Montana, New Hampshire and North Carolina -- for voting against increased funding for VA or military health-care programs. In Colorado, where Rep. Cory Gardner (R) is hoping to unseat Sen. Mark Udall (D), the DSCC has said that Gardner "has a lot to be ashamed of" and "has hurt veterans" by voting against increases in VA budgets and additional federal funding for prosthetic research and development.

Among conservative groups, Concerned Veterans for America -- which is funded in part with donations from the wealthy industrialists Charles and David Koch -- is airing online and TV ads targeting Democratic Sens. Mark Pryor (Ark.), Kay Hagan (N.C.), Mary Landrieu (La.), Jeanne Shaheen (N.H.) and Mark R. Warner (Va.) and Senate Majority Leader Harry M. Reid (Nev.). Crossroads GPS, a group working to elect Republican senators, also has aired ads blaming Sen. Mark Begich (D-Alaska), who sits on the Senate Veterans' Affairs Committee, for the troubles at the VA.

Miller said last week that the issue of veterans' care "should not be a political football." And Sanders said he's very concerned about "the increased politicization of the VA," calling news of new attack ads "very unfortunate."